Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
Centre for Women's Health Research, School of Medicine and Public Health, University of Newcastle, New South Wales, Australia.
BMC Pediatr. 2022 Feb 28;22(1):108. doi: 10.1186/s12887-022-03169-6.
Studies assessing the association between short birth interval, a birth-to-birth interval of less than 33 months, and under-five undernutrition have produced inconclusive results. This study aimed to assess the relationship between short birth interval and outcomes of stunting, underweight, and wasting among children aged under-five in Ethiopia, and potential mediation of any associations by maternal anemia and baby birth size.
Data from the 2016 Ethiopia Demographic and Health Survey (EDHS) was used. Stunting, wasting, and underweight among children aged under-five were outcome variables. Generalized Structural Equation Modeling (GSEM) was used to examine associations between short birth interval and outcomes, and to assess hypothesized mediation by maternal anemia and baby birth size.
Significant associations between short birth interval and stunting (AOR = 1.49; 95% CI = 1.35, 1.66) and underweight (AOR = 1.43; 95% CI = 1.28, 1.61) were found. There was no observed association between short birth interval and wasting (AOR = 1.05; 95% CI = 0.90, 1.23). Maternal anemia and baby birth size had a significant partial mediation effect on the association between short birth interval and stunting (the coefficient reduced from β = 0.337, p < 0.001 to β = 0.286, p < 0.001) and underweight (the coefficient reduced from β = 0.449, p < 0.001 to β = 0.338, p < 0.001). Maternal anemia and baby birth size mediated 4.2% and 4.6% of the total effect of short birth interval on stunting and underweight, respectively.
Maternal anemia and baby birth size were identified as mediators of the association between short birth interval and under-five undernutrition status. Policies and programs targeting the reduction of under-five undernutrition should integrate strategies to reduce maternal anemia and small baby birth size in addition to short birth interval.
评估出生间隔时间短（少于 33 个月的出生到出生间隔）与五岁以下儿童营养不足之间关系的研究结果尚无定论。本研究旨在评估出生间隔时间短与埃塞俄比亚五岁以下儿童发育迟缓、体重不足和消瘦结局之间的关系，并评估母婴贫血和婴儿出生体重对任何关联的潜在中介作用。
使用 2016 年埃塞俄比亚人口与健康调查（EDHS）的数据。五岁以下儿童的发育迟缓、消瘦和体重不足为结局变量。使用广义结构方程模型（GSEM）来检验出生间隔时间短与结局之间的关联，并评估母婴贫血和婴儿出生体重对假设中介作用的影响。
出生间隔时间短与发育迟缓（AOR=1.49；95%CI=1.35, 1.66）和体重不足（AOR=1.43；95%CI=1.28, 1.61）之间存在显著关联。出生间隔时间短与消瘦之间没有观察到关联（AOR=1.05；95%CI=0.90, 1.23）。母婴贫血和婴儿出生体重对出生间隔时间短与发育迟缓（从β=0.337，p<0.001 减少到β=0.286，p<0.001）和体重不足（从β=0.449，p<0.001 减少到β=0.338，p<0.001）之间的关联有显著的部分中介作用。母婴贫血和婴儿出生体重分别介导了出生间隔时间短对发育迟缓和体重不足的总效应的 4.2%和 4.6%。
母婴贫血和婴儿出生体重被确定为出生间隔时间短与五岁以下儿童营养不足状况之间关联的中介因素。针对减少五岁以下儿童营养不足的政策和方案应除了缩短出生间隔时间外，还应整合减少母婴贫血和婴儿出生体重的策略。
